The must-read stories and debate in health policy and leadership.

Teething problems?

HSJ has published a lengthy investigation into the operation of the new Healthcare Safety Investigation Branch, including concerns raised by multiple whistleblowers.

These insiders, who were all united in the view that HSIB was designed to do important work, spoke out about what they believed was a poor culture and governance at the fledgling watchdog.

To its credit, HSIB hasn’t ducked the issues. Chief investigator Keith Conradi gave a detailed interview to HSJ in which he accepted the organisation had made some mistakes.

It is clear that taking on 1,200 maternity incident investigations from the NHS was a big ask and required a huge expansion, with HSIB’s budget rising from £3.8m to £20m in 2019.

The original idea was for HSIB to act as an air accident investigation type body, investigating serious safety incidents using a new methodology and providing learning to the whole system.

HSIB is now a maternity investigation body, that does some national investigations on the side. It is at risk of being diverted from its original aims.

The issues set out in HSJ’s investigation may be teething problems, and planned legislation for HSIB could resolve much of the concerns around governance.

But to have so many whistleblowers, in such a short period of time, has to be a worry for the organisation.

Not splashing the cash

NHS providers have, once again, received tens of millions less than promised to improve their IT, HSJ revealed on Wednesday.

Figures disclosed by NHS Digital have shown that in two of the biggest priority areas for NHS IT – digitising providers and improving cyber security – nearly £100m less was spent than planned in 2018-19.

For NHS providers, it is the third year running that the centre has spent less than promised on helping them improve their IT. Three years into the “digital transformation” programme, the centre had planned to spend about £560m on trusts. Instead, it has spent about £300m.

It also appears that, after a boost in cyber security funding in 2017-18 following the WannaCry attack, spending slumped £22.9m last year, £34.3m less than budgeted.

NSH England said NHS Digital’s figures don’t account for all central digital spending and the money that didn’t quite make it to trusts to improve cyber security or IT last year will be rolled over to this year.

However, with the backlog of money that needs to be spent on digital technology before April 2021 piling up, there are legitimate concerns that, like central tech funds before it, delays in funding will amount to significant cuts to money available for digital transformation.